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STEMI: A Matter of Life and Death
February 7, 2017
You may not know what STEMI is, but you definitely know someone who has been affected by it.
STEMI stands for ST-Elevated Myocardial Infarction. It occurs when one of the main vessels of the heart becomes blocked or narrows due to a buildup of fat, cholesterol and other substances that are together called plaque. In other words, it is a heart attack.
STEMIs are identified through an electrocardiogram, also called an “EKG” or “ECG.” When a reading shows a possible heart attack, the patient is taken directly to the Cardiac Catheterization Lab to have a Percutaneous Intervention or ”PCI” which inserts a wire (typically into the femoral artery of the leg) and threads it through until it reaches the heart. Once in the heart, an Interventional Cardiologist and his/her team can use balloons and stents to open the blocked vessel and relieve the STEMI.
All heart attacks have beginnings, and it is extremely important to know the signs and symptoms.
The most common signs of STEMI are crushing chest pain (like an elephant sitting on your chest), radiating arm pain, and shortness of breath. It is also not uncommon for someone to sweat profusely, feel nauseous, and feel suddenly fatigued. For women the signs may be different. Women may experience shortness of breath, weakness, fatigue, loss of sensation in fingertips, or abdominal pain.
If you or someone you know is experiencing these symptoms, call 911 immediately for an ambulance. If you call 911, an ambulance will come staffed and ready to perform the EKG, either there on the spot or on the way to a hospital. This way, if you are having a heart attack, you can go directly to a Catheterization Lab when you get to the hospital rather than wait for tests to be performed.
This may save you crucial minutes. For every minute that the heart is failing, tissue is dying.
Rapid response is so important at this time that “door-to-balloon time” has become a key measure of quality care.
A door-to-balloon time of less than 90 minutes is recommended. At Providence Health, the average door-to-balloon time is 52 minutes (which includes include all patients presenting to the Providence Health Emergency Department downtown via ambulance, private vehicle, or as transfers in from other facilities). Since time is muscle, that represents a significant amount of tissue – and lives -- saved.
Aside from starting the EKG to confirm the diagnosis needed to get “to balloon,” an EMS team has capabilities and resources to start care on the way to the hospital. That is why we encourage people to call 911, even when they think they can drive, even when they have someone who can drive them. It’s not about the demands of driving… it’s about the delay of care.
So while yes, STEMI stands for ST-Elevated Myocardial Infarction, I like to think it stands for something else, too.
For more information about cardiac care provided by Providence Health, visit: http://yourprovidencehealth.com/our-services/cardiac-care
Written by Jarrod Moody, MBA, EMT - STEMI/EMS Outreach, Chest Pain Center Coordinator, Providence Health